Tag: statistics

Phys Eng Sci Med. 2022 Nov 10. doi: 10.1007/s13246-022-01196-2. Online ahead of print.

ABSTRACT

The study aims to implement a convolutional neural network framework that uses the 18F-FDG PET modality of brain imaging to detect multiple stages of dementia, including Early Mild Cognitive Impairment (EMCI) and Late Mild Cognitive Impairment (LMCI), and Alzheimer’s disease (AD) from Cognitively Normal (CN), and assess the results. 18F-FDG PET imaging modality for brain were procured from Alzheimer’s disease neuroimaging initiative’s (ADNI) repository. The ResNet50V2 model layers were utilised for feature extraction, with the final convolutional layers fine-tuned for this dataset’s multi-classification objectives. Multiple metrics and feature maps were utilized to scrutinize and evaluate the model’s statistical and qualitative inference. The multi-classification model achieved an overarching accuracy of 98.44% and Area under the receiver operating characteristic curve of 95% on the testing set. Feature maps aided in deducing finer aspects of the model’s overall operation. This framework helped classifying from the 18F-FDG PET brain images, the subtypes of Mild Cognitive Impairment (MCI) which include EMCI, LMCI, from AD, CN groups and achieved an all-inclusive sensitivity of 94% and specificity of 95% respectively.

PMID:36357627 | DOI:10.1007/s13246-022-01196-2

Eur Arch Otorhinolaryngol. 2022 Nov 10. doi: 10.1007/s00405-022-07730-y. Online ahead of print.

ABSTRACT

BACKGROUND: Several reports examined the survival of laryngeal cancer (LC) patients, most of these studies only focused on the prognosis of the disease, and just a small number of studies examined non-cancer-related causes of death. The objective of the current study is to investigate and quantify the most common causes of deaths following LC diagnosis.

METHODS: The data of 44,028 patient with LC in the United States diagnosed between 2000 and 2018 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) program and analyzed. We stratified LC patients according to various demographic and clinical parameters and calculated standardized mortality ratios (SMRs) for all causes of death.

RESULTS: Over the follow-up period, 25,407 (57.7%) deaths were reported. The highest fatalities (11,121; 43.8%) occurred within 1-5 years following LC diagnosis. Non-cancer causes of death is the leading cause of death (8945; 35.2%), followed by deaths due to laryngeal cancer (8,705; 34.3%), then other cancers deaths (7757; 30.5%). The most common non-cancer causes of death were heart diseases (N = 2953; SMR 4.42), followed by other non-cancer causes of death (N = 1512; SMR 3.93), chronic obstructive pulmonary diseases (N = 1420; SMR 4.90), then cerebrovascular diseases (N = 547; SMR 4.28). Compared to the general population, LC patients had a statistically significant higher risk of death from all reported causes.

CONCLUSIONS: Non-cancer causes of death is the leading cause of death in LC patients, exceeding deaths attributed to LC itself. These findings provide important insight into how LC survivors should be counselled regarding future health risks.

PMID:36357608 | DOI:10.1007/s00405-022-07730-y

Intern Emerg Med. 2022 Nov 10. doi: 10.1007/s11739-022-03124-4. Online ahead of print.

ABSTRACT

To date, we do not know if the excess of the body mass index (BMI) improves or worsens the outcomes in colorectal cancer treatment, and the correlation between BMI and prognosis remains unclear. A recent study in vitro showed a significant negative correlation between BMI and Cetuximab-induced antibody-dependent cellular cytotoxicity. On these bases, we tried to analyze the potential correlation between BMI and survival in patients affected by metastatic colorectal cancer (mCRC) and treated with Cetuximab. Retrospective data were collected from 132 patients affected by mCRC treated with Cetuximab in monotherapy or association with chemotherapy between January 2007 and October 2019. The cohort of patients was divided into different groups according to the World Health Organization (WHO) BMI classification: underweight (BMI < 18.59), normal weight (BMI 18.5-24.9,) overweight (BMI 25-29.9), and obese (BMI > 30), and we observed the influence of BMI on survival and treatment response. Patients with BMI ≥ 25 had statistically significantly better survival than patients BMI < 25 (19 vs 10 months, p = 0.025). Dividing the sample into the four WHO BMI categories, the best survival rates were seen in the overweight and obese subgroups (18 and 26 months respectively, p < 0.01). The multivariate analysis confirmed BMI as the only parameter able to influence survival. No correlation between BMI and treatment response was seen between BMI ≥ 25 and BMI ≤ 24 groups (p = 0.14). Our experience suggests that mild obese and overweight patients treated with Cetuximab could experience a better survival. We also observed that among normal weight, overweight, and mild obese patients, there is a better response to immunochemotherapy in comparison with underweight patients, but this difference does not reach a significative statistical value.

PMID:36357605 | DOI:10.1007/s11739-022-03124-4

World J Urol. 2022 Nov 11. doi: 10.1007/s00345-022-04207-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess if systematic (SBx) vs. transrectal or transperineal mpMRI-ultrasound targeted combined with systematic (TBx + SBx) biopsy confer different effects on treatment delay to radical prostatectomy measured as Gleason grade group (GGG) upgrade of prostate cancer (PCa).

MATERIALS AND METHODS: We relied on a multi-institutional cohort of localized PCa patients who underwent RP in Martini-Klinik, Hamburg, or Prostate Center Northwest, Gronau, between 2014 and 2022. Analyses were restricted to PCa GGG 1-3 diagnosed at SBx (n = 4475) or TBx + SBx (n = 1282). Multivariable logistic regression modeling (MVA) predicting RP GGG upgrade of ≥ 1 was performed separately for SBx and TBx + SBx.

RESULTS: Treatment delay to RP of < 90, 90-180 and 180-365 days was reported in 59%, 35% and 6.2% of SBx and in 60%, 34% and 5.9% of the TBx + SBx patients, respectively. Upgrade to GGG ≥ 4 at RP was detected in 15% of SBx patients and 0.86% of TBx patients. In MVA performed for SBx, treatment delay yielded independent predictor status (OR 1.17 95% CI 1.02-1.39, p = 0.028), whereas for TBx + SBx MVA, statistical significance was not achieved.

CONCLUSION: Treatment delay remained independently associated with radical prostatectomy GGG upgrade after adjustment for clinical variables in the patients diagnosed with SBx alone, but not in those who received combined TBx + SBx. These findings can be explained through inherent misclassification rates of SBx, potentially obfuscating historical observations of natural PCa progression and potential dangers of treatment delay. Thus, mpMRI-guided combined TBx + SBx appears mandatory for prospective delay-based examinations of PCa.

PMID:36357604 | DOI:10.1007/s00345-022-04207-9

N Z Med J. 2022 Nov 11;135(1565):41-50.

ABSTRACT

In Aotearoa New Zealand, people regularly travel away from their home to receive hospital care. While the role of whānau support for patients in hospital is critical for Māori, there is little information about away-from-home hospitalisations. This paper describes the frequency and patterning of away-from-home hospitalisations and inter-hospital transfers for Māori. Data from the National Minimum Dataset (NMDS), for the 6-year period of 1 January 2009-31 December 2014, were analysed. Basic frequencies, means and descriptive statistics were produced using SAS software. We found that more than 10% of all routine hospitalisations constituted an away-from-home hospitalisation for Māori; that is, a hospitalisation that was in a district health board (DHB) other than the DHB of usual residence for the patient. One quarter (25.19%) of transfer hospitalisations were to a DHB other than the patient’s DHB of domicile. Away-from-home hospital admissions increase for Māori as deprivation increases for both routine and transfer admissions, with over half of Māori hospital admissions among people who live in areas of high deprivation. This analysis aids in understanding away-from-home hospitalisations for Māori whānau, the characteristics associated with these types of hospitalisations and supports the development and implementation of policies which better meet whānau Māori needs. The cumulative impact of the need to travel to hospital for care, levels of poverty and a primarily reimbursement-based travel assistance system all perpetuate an unequal cost burden placed upon Māori whānau.

PMID:36356268

N Z Med J. 2022 Nov 11;135(1565):12-22.

ABSTRACT

AIMS: To examine if differences exist between injured Māori and non-Māori in accessing and receiving support from the Accident Compensation Corporation (ACC) for treatment and rehabilitation of subsequent injuries.

METHODS: This cohort study utilised participants’ self-reported data from the Prospective Outcomes of Injury Study, and ACC claims data.

RESULTS: Approximately one-third of Māori (32%) and non-Māori (35%) who self-reported a subsequent injury had no associated ACC claim. Statistically significant differences in this outcome (i.e., self-reported subsequent injury but no ACC claim) were found between Māori and non-Māori when comparing across occupation type and severity of participants’ sentinel injuries. Few differences were observed between Māori and non-Māori in the percentages of ACC claims accepted that compensated various treatments and supports; this was similar for average compensation amounts provided.

CONCLUSIONS: Māori and non-Māori who received support from ACC for a sentinel injury prior to sustaining another injury appear to have received equitable ACC compensation for the treatment and rehabilitation of the subsequent injury with two potential exceptions. Further research is needed to determine how generalisable these findings are. Establishing routine systems for collecting data about the support needed, treatment pathways and outcomes once accessing ACC support is vital to ensure positive and equitable injury outcomes for Māori.

PMID:36356265

J Appl Physiol (1985). 2022 Nov 10. doi: 10.1152/japplphysiol.00113.2022. Online ahead of print.

ABSTRACT

In healthy individuals, loading inspiratory muscles by brief inspiratory occlusion produces a short-latency inhibitory reflex (IR) in the electromyographic activity (EMG) of scalene and diaphragm muscles. This IR may play a protective role to prevent aspiration and airway collapse during sleep. In people with motor and sensory complete cervical spinal cord injury (cSCI), who were able to breathe independently, this IR was predominantly absent. Here, we investigated the reflex response to brief airway occlusion in 16 participants with sensory incomplete cSCI (American Spinal Injury Association Impairment Scale (AIS) score B or C). Surface EMG was recorded from scalene muscles and the lateral chest wall (overlying diaphragm). The airway occlusion evoked a small change in mouth pressure resembling a physiological occlusion. The short-latency IR was present in 10 (63%) sensory incomplete cSCI participants; significantly higher than the IR incidence observed in complete cSCI participants in our previous study (14%; p=0.003). When present, mean IR latency across all muscles was 58 ms (range 29-79 ms) and mean rectified EMG amplitude decreased to 37% pre-occlusion levels. Participants without an IR had untreated severe obstructive sleep apnoea (OSA), in contrast to those with an IR, who had either had no, mild or treated OSA (p=0.002). Insufficient power did not allow statistical comparison between IR presence, or absence and participant clinical characteristics. In conclusion, spared sensory connections or intersegmental connections may be necessary to generate the IR. Future studies to establish whether IR presence is related to respiratory morbidity in the tetraplegic population are required.

PMID:36356259 | DOI:10.1152/japplphysiol.00113.2022

Obstet Gynecol. 2022 Sep 1;140(3):519-520. doi: 10.1097/AOG.0000000000004910.

NO ABSTRACT

PMID:36356240 | DOI:10.1097/AOG.0000000000004910

Scand J Work Environ Health. 2022 Nov 10:4069. doi: 10.5271/sjweh.4069. Online ahead of print.

ABSTRACT

OBJECTIVE: Jobs characterized by low job demands and high job resources are associated with better work outcomes, yet it remains unclear whether this is the case for workers with depression. This study examined whether depression moderates the relationship between job demands, job resources, and maintaining employment.

METHODS: Data from the longitudinal population-based Lifelines cohort study were matched with register data on employment from Statistics Netherlands (N=55 950). Job demands included quantitative demands and work pace; job resources included influence at work and possibilities for development. The two-way interaction between job demands and depression and the three-way interaction between job demands, job resources and depression were examined in a zero-inflated Poisson regression model with path 1, including a binary employment outcome, and path 2, a count variable including months out of employment.

RESULTS: The interaction effect of job demands and depression on being employed was significant [b=-0.22, 95% confidence interval (CI) -0.44‒0.01]. Workers without depression were more likely to be employed whereas workers with depression were less likely to be employed if they had high job demands. The three-way interaction between job demands, job resources, and depression was significant for months out of employment (b=0.15, 95% CI 0.01‒0.29), indicating that workers with depression had more months out of employment when reporting high job demands and high job resources compared to workers without depression. Discussion Although increasing influence at work and possibilities for development to prevent negative work outcomes may be beneficial for workers without depression, this approach might be limited for workers with depression.

PMID:36356230 | DOI:10.5271/sjweh.4069

J Biomed Mater Res B Appl Biomater. 2022 Nov 10. doi: 10.1002/jbm.b.35193. Online ahead of print.

ABSTRACT

The use of inert head materials such as ceramic heads has been proposed as a method of reducing wear and corrosion products from the articulating surfaces in total hip arthroplasty, as well as from the stem-head taper connection. The aim of the present study was to compare the blood metal ion levels in patients with Oxinium and CoCrMo modular femoral heads, as well as monoblock stainless steel Charnley prostheses at 10 years postoperatively. The 150 patients with osteoarthritis of the hip joint included in a randomized clinical trial were grouped according to femoral head material. One group (n = 30) had received the Charnley monoblock stainless steel stem (DePuy, UK). The other patients (n = 120) received a Spectron EF CoCrMo stem with either a 28 mm CoCrMo or Oxinium modular head (Smith & Nephew, USA). After 10 years, 38 patients had withdrawn, 19 deceased, 7 revised due to aseptic loosening and 5 revised due to infection. The 81 patients with median age of 79 years (70-91) were available for whole blood metal ion analysis. The levels of Co, Cr, Ni and Zr in the blood were generally low with all the head materials (medians <0.3 micrograms/L) and no statistical difference between the groups were found (p = .2-.8). Based on the low blood metal ion values in our study groups, no indication of severe trunnion corrosion in patients with CoCrMo heads was observed, neither was there any beneficial reduction in metal ion exposure with the Oxinium femoral heads.

PMID:36356214 | DOI:10.1002/jbm.b.35193